1. Chapter 6 Goals Page 187 Students will be able to:
Define new suffixes & use them to form terms related to the digestive system.
List & explain laboratory tests, clinical procedures, & abbreviations relevant to the digestive system
Apply your new knowledge to understanding medical terms in their proper context, such as in medical reports & records & in personal vignettes.

2. Additional Suffixes & Digestive System Terminology
Chapter 6
Pages 187 – 214

3. Laboratory Tests & Clinical Procedures
Page 193
Laboratory Tests & Clinical Procedures
Laboratory Tests
Amylase & Lipase Tests
Tests for the levels of amylase & lipases enzymes in the blood
Increase levels are associated with pancreatitis
Stool Culture
Test for microorganisms present in feces.
Feces are placed in a growth medium & examined microscopically

4. Laboratory Tests & Clinical Procedures: Cont.
Page 193
Laboratory Tests & Clinical Procedures: Cont.
Liver Function Tests (LFTs)
Tests for the presence of enzymes & bilirubin in blood
LFTs are performed on blood serum (clear fluid that remains after blood has clotted). Examples of LFTs are tests for ALT (alanine transaminase) & AST (aspartate transaminase). ALT & AST are enzymes present in many tissues. Levels are elevated in the serum of patients with liver disease. High ALT & AST levels indicated damage to liver cells (as in hepatitis)

5. Laboratory Tests & Clinical Procedures: Cont.
Page 193
Laboratory Tests & Clinical Procedures: Cont.
Liver Function Tests (LFTs)
Alkaline phosphatase (alk phos) is another enzyme that may be elevated in patients with liver, bone, & other diseases.
Serum bilirubin levels are elevated in patients with liver disease & jaundice. A direct bilirubin test measures conjugated bilirubin. High levels indicate liver disease or biliary obstruction. An indirect bilirubin test measures unconjugated bilirubin. Increased levels suggest excessive hemolysis, as may occur in a newborn.

6. Laboratory Tests & Clinical Procedures: Cont.
Page 193
Laboratory Tests & Clinical Procedures: Cont.
Stool Guaiac Test or Hemoccult Test
Test to detect occult (hidden) blood in feces
This is an important screening test for colon cancer. Guaiac is a chemical from the wood of trees. When added to a stool sample, it reacts with any blood present in the feces.

7. Laboratory Tests & Clinical Procedures: Cont.
Page 194
Laboratory Tests & Clinical Procedures: Cont.
Clinical Procedures
X-Ray Tests
X-ray imagining is used in many ways to detect pathologic conditions. In dental practice, x-ray images are commonly use to locate cavities (caries). Many of the x-ray tests listed here use a contrast medium (substance that x-rays cannot penetrate) to visualize a specific area of the digestive system.
The contrast, because of its increased density relative to body tissue, allows organs & parts to be distinguished from one another on the film or screen.

8. Laboratory Tests & Clinical Procedures: Cont.
Page 194
Laboratory Tests & Clinical Procedures: Cont.
Lower Gastrointestinal Series (barium enema)
X-ray image of the colon & rectum obtained after injection of barium into the rectum
Radiologists inject barium (a contrast medium) by enema into the rectum

9. Laboratory Tests & Clinical Procedures: Cont.
Page 194
Laboratory Tests & Clinical Procedures: Cont.
Upper Gastrointestinal Series
X-ray image of the esophagus, stomach, & small intestine obtained after administering barium by mouth
Often performed immediately after an upper gastrointestinal series, a small bowel follow-through study shows sequential x-ray pictures of the small intestine as barium passes through. A barium swallow is a study of the esophagus.

10. Laboratory Tests & Clinical Procedures: Cont.
Page 194
Laboratory Tests & Clinical Procedures: Cont.
Cholangiography
X-ray examination of the biliary system performed after injection of contrast into the bile ducts.
In percutaneous transheptic cholangiography, the contrast medium is injected using a needle placed through the abdominal wall into the biliary vessels of the liver. In endoscopic retrograde cholangiopancreatography (ERCP) contrast medium is administered through an oral catheter (tube) & then passes through the esophagus, stomach, & duodenum & into bile ducts. This procedure helps diagnose problems involving the bile ducts, gallbladder, & pancreas.

11. Laboratory Tests & Clinical Procedures: Cont.
Page 195
Laboratory Tests & Clinical Procedures: Cont.
computed tomography (CT)
A series of x-ray images are taken in multiple views (especially cross section)
A CT scan uses a circular array of x-ray beams to produce the cross-sectional image based on difference in tissue densities. Use of contrast material allows visualization of organs & blood vessels & highlights differences in blood flow between normal & disease tissues. Tomography produces a series of x-ray pictures showing multiple views of an organ. An earlier name for a CT scan is "CAT scan" (computerized axial tomography scan).

12. Laboratory Tests & Clinical Procedures: Cont.
Page 196
Laboratory Tests & Clinical Procedures: Cont.
Ultrasound Examinations
abdominal ultrasonography
Sound waves beamed into the abdomen produce an image of abdominal viscera
Ultrasonography is especially useful for examination of fluid-filled structures such as the gallbladder

13. Laboratory Tests & Clinical Procedures: Cont.
Page 196
Laboratory Tests & Clinical Procedures: Cont.
endoscopic ultrasonography (EUS)
Use of an endoscope combined with ultrasound to examine the organs of the gastrointestinal tract.
An endoscope is inserted through the mouth or rectum, & ultrasound images are obtained. This test is often used in assessing esophageal, pancreatic, & rectal cancer.

14. Laboratory Tests & Clinical Procedures: Cont.
Page 196
Laboratory Tests & Clinical Procedures: Cont.
Magnetic Resonance Imaging
magnetic resonance imaging (MRI)
Magnetic waves produce images of organs & tissues in all three planes of the body
This technique does not use x-rays. It detects subtle difference in tissue composition, water content, & blood vessel density & can show sites of trauma, infection, or cancer.
CT scanning would not have shown lesions as clearly as MRI

15. Laboratory Tests & Clinical Procedures: Cont.
Page 197
Laboratory Tests & Clinical Procedures: Cont.
Nuclear Medicine Test
HIDA Scan
Radioactive imaging procedure that tracks the production & flow of bile from the liver & gallbladder to the intestine
HIDA stands for hepatobiliary iminodiacetic acid. Cholescintigraphy is another name for this test, which determines if the gallbladder is functioning properly.

16. Laboratory Tests & Clinical Procedures: Cont.
Page 197
Laboratory Tests & Clinical Procedures: Cont.
Other Procedures
gastric bypass or bariatric surgery
Reducing the size of the stomach & diverting food to the jejunum (gastrojejunostomy).
This is bariatric surgery for severe obesity. The Roux-en-Y gastric bypass procedure reduces the size of the stomach to a volume of 2 tablespoons & bypasses much of the small intestine. The name Roux-en-Y comes from the surgeon who first described it (Cesar Roux) & anastomosis of the duodenum & jejunum, which looks like the letter Y.

17. Laboratory Tests & Clinical Procedures: Cont.
Page 198
Laboratory Tests & Clinical Procedures: Cont.
gastrointestinal endoscopy
Visual examination of the gastrointestinal tract using an endoscope.
A physician places a flexible fiberoptic tube through the mouth or the anus to view parts of the gastrointestinal tract. Examples are esophagogastroduodenoscopy (EGD), colonoscopy, sigmoidoscopy, proctoscopy, & anoscopy.
Virtual colonscopy (CT colongraphy) combines CT scanning & computer technology to enable physicians to examine the entire length of the colon by x-ray imaging in just minutes. Patients with abnormal findings require conventional colonoscopy afterward for further assessment or treatment, such as with biopsy or polypectomy.

18. Laboratory Tests & Clinical Procedures: Cont.
Page 199
Laboratory Tests & Clinical Procedures: Cont.
Laparoscopy
Visual (endoscopic) examination of the abdomen with a laparoscope inserted through small incisions in the abdomen.
Laparoscopic cholecystectomy & laparoscopic appendectomy are performed by gastrointestinal & general surgeons.

19. Laboratory Tests & Clinical Procedures: Cont.
Page 199
Laboratory Tests & Clinical Procedures: Cont.
Liver Biopsy
Removal of liver tissue for microscopic examination
A physician inserts a needle through the skin to remove a small piece of tissue for microscopic examination. The average sample is less than 1 inch long. The procedure helps doctors diagnose cirrhosis, chronic hepatitis, & tumors of the liver.

20. Laboratory Tests & Clinical Procedures: Cont.
Page 199
Laboratory Tests & Clinical Procedures: Cont.
Nasogastric Intubation
Insertion of a tube through the nose into the stomach
Physicians use a nasogastric (NG) tube to remove fluid postoperatively & to obtain gastric or intestinal contents for analysis

21. Laboratory Tests & Clinical Procedures: Cont.
Page 199
Laboratory Tests & Clinical Procedures: Cont.
Paracentesis (abdominocentesis)
Surgical puncture to remove fluid from the abdomen
This procedure is necessary to drain fluid (accumulated in ascites) from the peritoneal (abdominal) cavity